Individual
MR. KEVIN B JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRANIAL PROSTHESIS
Contact information
Practice address
2569 COUNTRYSIDE BLVD, BUILDING 20 SUITE 127, CLEARWATER, FL 33761
(727) 408-9049
Mailing address
2569 COUNTRYSIDE BLVD, CLEARWATER, FL 33761-3581
(727) 460-1221
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
BB8897104
FL
Other
Enumeration date
07/08/2026
Last updated
07/08/2026
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